The present invention relates to apparatuses for surgical instruments. In particular, the present invention relates to an apparatus for continuously accounting for instruments that enter and leave the operating environment. In preparation for surgery, an instrument pack, or tray of surgical instruments, is brought into an operating room. Both tray and instruments have been previously sterilized in an autoclave. The instrument pack contains an assortment of instruments, including hemostats, clamps, forceps, scissors, and the like, based on the type of surgery to be performed.
A scrub nurse removes the instruments from the pack and carefully arranges them on a table, called the back table, behind the operating table. Instruments are organized in rows on rolled toweling so that they may be easily and quickly viewed and grasped during the operation for handing to the surgeon handle end first.
In the course of surgery, a large number of instruments may be used in the operating environment. Some of these are held by the surgeons or other operating staff; others, such as clamps, are in use in the patient. After use or between uses, each used instrument is set aside on a "Mayo" stand. The back table is used primarily for sterilized, unused instruments.
All instruments must be carefully accounted for at the conclusion of surgery to avoid leaving instruments in the patient.
Accounting for instruments is done three times during the operation by the nurses. The first count is done before the start of the operation; the second, at the start of closure of the patient; and the third, at the start of skin closure.
A discrepancy in the count must be resolved by additional counts, by physical examination of the patient, operating suite, or by x-ray examination if necessary. Although it is unusual for a discrepancy in the count to result from an instrument still in the patient, counting and recounting occurs in every operation. These three mandatory accountings are time consuming, tie up professional personnel, contribute to operating room suite down time, costs the hospital money, costs the insurance companies money, costs the patient money, costs the physician money, distracts personnel during the surgical procedure, lengthens the time the patient is exposed to the anesthesia thus increasing mortality/morbidity risk, and are generally distasteful to all involved. Thus, the time required for searching and accounting for surgical instruments introduced into the operating environment is critical.
The prior art contains a variety of holders for surgical instruments, typically trays for holding a stack of like instruments for sterilization but not also for dispensing and counting.
U.S. Pat. No. 3,802,555 issued to Grasty, et al., discloses a surgical instrument package and handling procedure comprising a set of trays having recessed compartments for surgical instruments. Counting is done visually and there is little flexibility in tailoring the type and number of instruments for different operations.
Freitag's Retaining and Inventory Pad for Surgical Sharps and Needles (U.S. Pat. No. 4,151,913) uses ridges with storing zones to control a limited class of surgical instruments. The instruments are counted visually.
Cheeseman, et al. disclose in U.S. Pat. No. 4,422,584 a Surgical Sponge Counter and Blood Loss Determination System having an array of pouches for used sponges about the periphery of a lined "kick" bucket.
None of the prior art patents discloses an apparatus that automatically counts the number of instruments used. None counts instruments dispensed into and removed from the operating environment. None eliminates the time, financial costs, and risk required to count and recount instruments to verify a missing instrument.
Accordingly, it is an object of the present invention to provide an apparatus for accounting for standard surgical instruments in the operating environment.
It is an object of the present invention to increase operating room suite and personnel utilization, and also decrease financial costs and patient risk.
It is another object of the present invention to provide an apparatus for determining the difference between the number of instruments dispensed into and the number received from the operating environment.
It is an object of the present invention to provide a sterilizable uniform dispenser for displaying and counting standard surgical instruments.
It is an object of the invention to provide a means for counting instruments stored on a Mayo stand.
It is an object of the invention to provide a process for determining the number of instruments entering and leaving the operating environment.